Rodnay Maya, Agbaria Nisreen, Neumark Yehuda, Guri-Scherman Anne-Laure Yehudit, Bar Zeev Yael
Braun School of Public Health and Community Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.
Nicotine Tob Res. 2025 May 22;27(6):962-969. doi: 10.1093/ntr/ntae291.
Secondhand smoke (SHS) exposure during pregnancy is associated with negative health outcomes. We aimed to explore Israeli pregnant women's perspectives on SHS exposure, with a focus on barriers and enablers to reducing SHS exposure at home and in the car.
Qualitative semi-structured telephone interviews with 68 women-54 Jewish and 14 Arab. Inclusion criteria: pregnant or up to 12 months post-partum; living with a person who smokes; age 18-45; Hebrew or Arabic speakers. Participants could be from any smoking status. Interviews were analyzed according to a reflective and collaborative thematic approach supported by the Capability (C) Opportunity (O) Motivation (M)-Behavior model.
Participants knew SHS is harmful, but a lack of specific knowledge (C) was evident across all smoking status groups and population groups (Jewish, Arab). Women harbored misconceptions regarding their SHS exposure (C), employing ineffective strategies to eliminate exposure. Many perceived smoking as a significant source of tension in their relationship with their partners (M). Women described feeling uncomfortable asking people to not smoke around them (O) and bemoaned the lack of support from health professionals (O). Women who never smoked or formerly smoked described situations where they felt trapped and helpless. Specifically, Arab participants reported social isolation (O). The living environment (eg, building with no elevator) was a commonly mentioned barrier to reduce home SHS exposure (O).
Despite high motivation, the low level of knowledge and negotiation skills, misconceptions about exposure and effective strategies, together with insufficient support lead to behaviors resulting in high SHS exposure.
This research explored women's experiences of SHS exposure during pregnancy, and barriers and enablers to reducing prenatal SHS exposure. Interventions need to empower pregnant women to feel confident in asking people not to smoke around them, focus on acquiring negotiation skills, raise awareness of actual exposure, and increase self-efficacy to use effective SHS reduction strategies. Interventions should be inclusive of all family members who smoke. These findings will inform the development of a digital intervention. Digital interventions have the potential for high reach among socially disadvantaged populations while allowing the tailoring of individualized messaging to the pregnant woman and her partner.
孕期接触二手烟（SHS）与不良健康后果相关。我们旨在探究以色列孕妇对接触二手烟的看法，重点关注在家中和车内减少二手烟接触的障碍和促进因素。
对68名女性进行定性半结构式电话访谈，其中54名犹太女性和14名阿拉伯女性。纳入标准：怀孕或产后12个月内；与吸烟者同住；年龄18 - 45岁；说希伯来语或阿拉伯语。参与者可以处于任何吸烟状态。访谈依据由能力（C）、机会（O）、动机（M）-行为模型支持的反思性和协作性主题方法进行分析。
参与者知道二手烟有害，但在所有吸烟状态组和人群组（犹太、阿拉伯）中都明显缺乏具体知识（C）。女性对自己接触二手烟存在误解（C），采用无效策略来消除接触。许多人认为吸烟是她们与伴侣关系中紧张情绪的重要来源（M）。女性表示让别人不在自己周围吸烟会感到不舒服（O），并抱怨缺乏健康专业人员的支持（O）。从不吸烟或曾经吸烟的女性描述了她们感到被困和无助的情况。具体而言，阿拉伯参与者报告存在社会隔离（O）。生活环境（如没有电梯的建筑）是减少家中二手烟接触时普遍提到的障碍（O）。
尽管动机强烈，但知识水平低、谈判技巧不足、对接触和有效策略的误解以及支持不足导致了二手烟接触率高的行为。
本研究探讨了孕妇接触二手烟的经历以及减少产前二手烟接触的障碍和促进因素。干预措施需要使孕妇有信心要求他人不在自己周围吸烟，注重培养谈判技巧，提高对实际接触的认识，并增强使用有效减少二手烟策略的自我效能感。干预措施应涵盖所有吸烟的家庭成员。这些发现将为数字干预的开发提供信息。数字干预有可能在社会弱势群体中广泛传播，同时允许为孕妇及其伴侣量身定制个性化信息。
